Organization
COALDALE CARDIOLOGY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT L DEJOSEPH MD (DIRECTOR)
(570) 645-0495
Entity
Organization
Contact information
Practice address
360 W RUDDLE ST, COALDALE, PA 18218-1027
(570) 645-0495
(570) 645-0497
Mailing address
360 W RUDDLE ST, COALDALE, PA 18218-1027
(570) 645-0495
(570) 645-0497
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD015292E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008165260001
—
PA
Enumeration date
07/26/2005
Last updated
08/22/2020
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